1. Field of the Invention
The invention relates to the fields of medicine and physiology, and especially to cardiovascular disease (CVD) treatment and prevention. In particular, the invention relates to a method for selecting an optimal diet and exercise regimen based, at least in part, on a low density lipoprotein (LDL) and high density lipoprotein (HDL) subclass (sometimes also referred to as “subfraction”) determination.
2. Description of the Related Art
Cardiovascular disease (CVD), principally heart disease and stroke, is the nation's leading killer of both men and women among all racial and ethnic groups. In particular, heart disease and stroke are the first and third leading causes of death in the United States, accounting for more than 40% of all deaths. About 950,000 Americans die of heart disease or stroke each year, which amounts to one death every 33 seconds. Looking at only deaths due to heart disease or stroke, however, understates the health effects of these two conditions: about 61 million Americans live with the effects of stroke or heart disease; heart disease is a leading cause of disability among working adults; stroke alone accounts for the disability of more than 1 million Americans; and almost 6 million hospitalizations each year are due to heart disease or stroke. Moreover, the economic effects of heart disease and stroke on the U.S. health care system grows larger as the population ages. In 2001, for example, the estimated cost of CVD was $298 billion, including health care expenditures and lost productivity.
Several behavioral risk factors (e.g., obesity and physical inactivity) and preventive practices (e.g., weight loss) are associated with the development of CVD. Obesity is associated with high rates of CVD deaths, especially sudden death among men and congestive heart failure among women. The high death rate might occur largely as a consequence of the influence of obesity on blood pressure, blood lipid levels, and the onset of diabetes; however, some studies indicate that obesity is also an independent risk factor for CVD. Physical inactivity has also been shown to be a major risk factor for heart disease. Additional evidence shows an association between regular moderate-intensity physical activity and the lowering of several other risk factors for CVD, including blood lipid levels, resting blood pressure among persons with borderline hypertension, body composition and overweight and glucose tolerance and insulin sensitivity. Weight control, meanwhile, is a first step in the control of mild hypertension hyperlipidemia, and impaired glucose tolerance and might eliminate the necessity of lifelong drug therapy for these conditions. Efforts to control weight generally have not been effective; however, researchers have demonstrated recently the effectiveness of combined programs of behavior modification of diet and exercise (Jeffery R W (1995) Obesity Research 3(suppl.):283s–288s; Brownell K D (1986) Annu Rev Public Health 7:521). Moreover, therapeutic approaches to weight control that emphasize increased physical activity have other benefits in addition to increasing caloric expenditure (Powell K E et al. (1987) Annu Rev Public Health 8:253).
Although it has been known for some time that an appropriate diet and exercise regimen may be useful in the prevention and treatment of CVD, there remains a need for methods of selecting an optimal diet and exercise regimen that may be used in the treatment and prevention of CVD. In particular, there is a need in the art for methods for selecting an optimal diet and exercise regimen based on the evaluation of risk factors such as LDL and HDL subclass levels. The present invention provides such methods.